Individual
MR. LUCAS ALLEN GROSSOEHME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1879 FERONIA AVE, SAINT PAUL, MN 55104-3549
(651) 646-4061
Mailing address
1879 FERONIA AVE, SAINT PAUL, MN 55104-3549
(651) 646-4061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0739339
MN
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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